T. I. M. E. ManagementNs. Alan A. Sondakh, S. Kep. CWCCAT. I. M.
E
T : Tissue Management Menghilangkan jaringan yang menghambat
penyembuhan lukaMenggunakan teknik debridementMengembalikan dasar
luka dan fisiologis penyembuhanHasil yang diharapkan Viable wound
baseI : Inflammation and Infection ControlHigh bacterial counts or
prolonged inflammation Inflammatory cytokines Growth factor
activityOutcome Bacterial balance and reduced inflammationDoes the
wound have signs of bacterial contamination, infection or
inflammation ?M : Moisture balanceDesiccation slows epithelial cell
migration Apply moisture-balancing dressings Restored epithelial
cell migration, desiccation avoidedExcessive fluid causes
maceration of wound margin control of exudates Oedema, excessive
fluid controlled, maceration avoidedBila luka berongga diisi.
(contoh, gunakan foam cavity)Bila luka basah diserap. (contoh,
gunakan ca. alginate)Bila luka kering dilembabkan. (contoh, gunakan
hydrocloid).Bila luka kotor bersihkan. (contoh, irigasi luka)
E : Ephitelial advancement / edgeWhen the epidermal margins of a
wound fail to migrate across the wound bed or the wound edges fail
to contract and reduce in size, consideration needs to have been
given to the T,I, and M first to ensure that all aspects of wound
bed preparation have been considered. The final stage of wound
healing is epithelialisation, which is the active division,
migration, and maturation of epidermal cells from the wound margin
across the open woundThere are many factors which need to be
present in order for epithelialisation to take place, such as:The
wound bed must be full of well vascularised granulation
tissueEnsures that there is adequate oxygen and nutrients to
support epidermal regenerationOther factors, such as bacteria or
the presence of devitalised tissue, which interfere with epidermal
cell growth
